We are hearing much about the prevention of the “lifestyle” (or non-communicable) diseases at the UN summit in New York, which is clearly a very good thing, but little about treatment for cancer, heart and lung disease and diabetes. Curiously, it was the other way round at the first UN high-level meeting on a health issue in 2001, when millions of people were dying from Aids.

But in these austere economic times - and indeed they are austere, as yesterday’s report into the gloomy prospects for the Global Fund pointed out - prevention looks by far the issue most likely to attract funding and consensus. There is also a stigma attached to overweight people who fall prey to heart disease and diabetes - though no worse than the one that people who contracted HIV had to deal with. There are also some cheap - because out of patent - generic drugs for conditions such as heart disease and asthma that everybody will agree should be available in the developing world.

So treatment is low down the agenda and it would appear that some donor governments are keen to keep it there. During the negotiations over the draft declaration that has now been signed by world leaders, the European Union and the United States were very anxious to keep out any mention of the words “Doha” and “TRIPS”. For those who haven’t followed the complex and hard-fought battles over access to HIV medicines, the issue here concerns drug patents.

After a long struggle and amid enormous public hostility to the pharmaceutical industry over its apparent foot-dragging in relation to access to (expensive, in-patent) Aids drugs for the poor in Africa and Asia, an historic agreement was made which is generally referred to as the Doha Declaration of the TRIPS legislation (trade-related aspects of intellectual property rights). This is where the World Health Organisation describes it.